Tag Archives: SGR

SGR Fix Already Revised and Hospital Outpatient Department $$ Reduced

The ink was barely dry on the Medicare Physician Sustainable Growth Rate (SGR) fix, and it has already been changed. One component of the SGR fix, which was just passed in April of this year, was freezing Medicare physician payments from 2019 through 2025, and then allowing a .75% increase for physicians participating in alternative … Continue Reading

CMS Releases Proposed 2015 Physician Fee Schedule and Projects 20.9% SGR Reduction

CMS has issued the Proposed 2015 Physician Fee Schedule and Fact Sheets for specific issues (ASC, ESRD, Home Health, Physician Quality Programs). SGR Reduction Although the Protecting Access to Medicare Act Prohibits any SGR reduction for the first 60 days of 2015, i.e., until March 1, 2015, CMS predicts a 20.9% decrease without legislative action. … Continue Reading

Joint SGR Repeal Bill Agreed Upon, Moving to Full Congress

New joint legislation to repeal Medicare’s failed SGR formula is advancing to both chambers of Congress following an agreement announced Thursday by the three committees that put forth repeal bills earlier this session. “The AMA congratulates House and Senate negotiators for taking this critical step toward reforming the nation’s Medicare program,” AMA President Ardis Dee … Continue Reading

SGR Update

I recently posted the SGR White Paper published jointly by the Senate Finance Committee and the House Ways and Means Committee. Earlier this week, both committees endorsed legislation enacting those concepts. The section by section summary of the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 is attached. Unfortunately, both the House and … Continue Reading

Joint House and Senate SGR White Paper Proposes Permanent SGR Repeal

The House Ways and Means Committee and the Senate Finance Committee have jointly issued a White Paper proposing the repeal of the Medicare Sustainable Growth Rate Formula, entitled “SGR Repeal and Medicare Physician Payment Reform”. The SGR white paper acknowledges that the Sustainable Growth Rate formula is “fundamentally broken” and that application of the SGR … Continue Reading

CMS Proposes 2014 Medicare Physician Fee Schedule; SGR Reduction Projected @ 24.4%

CMS has issued the poroposed Medicare Physician Fee Schedule. Without Congressional intervention, the SGR will mandate a 24.4% decrease. CMS sent its calcuations to the Medare Payment Advisory Commission.   http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SustainableGRatesConFact/Downloads/SGR2013-Final-Signed.pdf CMS has also issued a Fact Sheet Summary:   http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2013-Fact-Sheets-Items/2013-07-08.html?DLPage=1&DLSort=0&DLSortDir=descending… Continue Reading

AMA Reports; Supercommittee Stalemate Leaves SGR 27.5 Physician Fee Schedule Decrease Intact

Supercommittee failure leaves 27 percent Medicare payment cut in place With the Joint Select Committee on Deficit Reduction failing to reach agreement on a deficit-reduction proposal, physicians still face a 27 percent cut in Medicare physician payments scheduled to take effect Jan. 1. Congress has missed an opportunity to address the nation’s fiscal problems, stabilize … Continue Reading

CMS Estimates 29.9% Decrease for 2012 Medicare Conversion Factor

The Social Security Act requires CMS to provide annual estimates to the Medicare Payment Advisory Commission (MedPAC) for both the Medicare Physician Fee Schedule Conversion Factor (SCF) and the Sustainable Growth Rate (SGR). According to the letter just released by Jonathan Blum, Deputy Administrator and Director for CMS, the 2012 Medicare Physician Fee Schedule Conversion Factor … Continue Reading

Senate Postpones 23% SGR Medicare Physician Fee Schedule Cut One Month

Senate Acts to Avert Medicare Physician Fee Cut By Nora Colangelo and Jacqueline Finnegan* On November 18, 2010, the Senate approved a bill that would postpone the scheduled 23% Medicare physician payment cut scheduled to take effect on December 1, 2010, for one month. If approved by the House of Representatives and signed into law … Continue Reading

Medicare SGR Developments

The U.S. House of Representatives is expected to consider legislation to block the pending 21.2 percent cut to physician Medicare payments soon. The cuts will take effect June 1 unless final legislation is signed into law before then. The proposed bill, H.R. 4213, “The American Jobs and Closing Tax Loopholes Act of 2010” also includes numerous other … Continue Reading

Medicare Physician Fee Schedule SGR 21.3% Decrease April 1, 2010

  Senate failure to pass 30-day extension causes 21.3 percent cut to Medicare physician payments on April 1.   The Senate has adjourned for 2 weeks without postponing the Sustainable Growth Rate (SGR) Medicare Physician Fee Schedule reduction. For the past several months, since the problem arose 1/1/10, carriers have responded by advising physicians to … Continue Reading

With Healthcare Reform Stalled – What Happens to the Medicare SGR Cut?

The stalled healthcare reform initiative leaves the Medicare Physician Fee Schedule problem of the Sustainable Growth Rate (SGR) imposed 21.5% reduction as a stand alone separate issue. The physician fee schedule decrease was postponed for 2 months by an Obama addition to a defense approriation bill, with the expectation that a long term solution would … Continue Reading